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I cover the State of West Virginia as part of my job. The people in West Virginia are largely the most respectful and kind people that you will ever find. When you drive in from Ohio or Pennsylvania you see the sign "Welcome to Wild and Wonderful West Virginia". I was stunned how overwhelming their support was for Donald J Trump. The amount of MAGA hats that I saw in the last campaigns was substantial. Unfortunately the people in West Virginia bought the Trump myth hook line and sinker. The attack on Medicaire by the billionaire class is beyond stupid. We are essentially going to remove medical coverage for millions of poor Americans because the 1% need another tax break. To make matters worse this is largely being done by a party that aligns itself with Christian Nationalists. Not sure what version of Jesus Christ they believe in? As I said to my employee Linda yesterday I will always remember being taught to sing a song in first grade at a Catholic elementary school in Ohio "And they know we are Christians by our love, by our love.....Not sure that those who have less are feeling the love? Completely lost on what Christian Nationalists actually believe in?

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Your West Virginia population (like all of the US) was repeatedly warned about the consequences of voting for Trump. Cutting taxes for the most wealthy and cutting services for the needy was always on the table. This should not be a surprise. They are getting what they voted for, and inflicting Trump on the rest of the US and world. I'm sorry, but I do not pity them for losing their health care now under Trump, as harsh as that may sound. They are getting exactly what they voted for, plain and simple. I hope they all stay healthy.

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You need to deepen your understanding. See my other post, please. You are condemning people who are living in conditions you can't imagine, and traumatized by the inescapability of that for believing the lying a**h**** who promised to make things great again. People often give their all to liars, frauds and cheats, out of a desperate need to believe they have something helpful to offer. It's sad. They deserve your understanding and compassion, not condemnation.

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I live in the South so I know a lot of MAGA people. Also have more than a few in my extended family. They are all well educated and financially well off. Some are quite rich. Some vote on the delusional idea that Trump will be better for the economy and they don't want to pay taxes but most just want to own the libs. The things some of them say is beyond hateful. One relative told my spouse they wanted to see all Democrats put to death — knowing he and our immediate family are all Democrats. These people are like millions of MAGA people. They deserve no sympathy.

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No, they don't. They are morally ugly.

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It’s more like they are our enemies.

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Let’s keep the war civil! Unlike the Civil War!

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Your economy is going to suffer more when Donald Trump puts Tariffs on Canada next week and the following weeks. Will hurt both of our Countries.

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I wonder if he actually will put tariffs on Canada and Mexico? I think he'll go after Europe next. If Canadians keep booing America he might hit with tariffs. He's that petty.

I can see tariffs going off China and hitting our former allies instead. Defiance and defense of democracy and rule of law will be hard for Trump/Musk to swallow.

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He started it. Starting next week and the following weeks

We are angry at Donald Trump No need for Tariffs. Prices will go up. Hurt both of our Countries needlessly.

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Exactly

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We “ have” to try understand them yet zero effort is made on their part to try to understand people like me who didn’t vote for Trump. Instead we are told to cry our “liberal tears” harder. So I’m done trying to understand people who have no interest in me . And frankly want to hurt me.

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You are conflating what you are seeing from well off assholes on Twitter with those people living in these rural depressed places. They don’t have the luxury of being terminally online.

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I bet they get plenty of their 'info' from X, Facebook, et al. so it's likely they are in fact online.

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They overwhelming condemn democrats and “the libs”. They vote for policies that are killing & subjugating women & minorities across the nation. I’m over being told to look at them with compassion & understanding. They are never told to look at us that way. Let’s look at them with compassion all the way to the gulag guys!

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Absolutely not. They deserve zero empathy. Their gullible hatred, bigotry and stupidity have put not only them in this position but millions more. along with all their offspring who will have to deal with climate change far worse than it needed to be. I hope all of them suffer in every way possible. To put it in terms they can understand, they Reap what they Sow. For the rest of us, its FAFO.

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I agree with you BUT....we have a knowledge base that's big enough so that a lot of this suffering is unnecessary. We have to at some point make peace with these people so we all sit down and do what is right. I am the Black Guy SICK of the racist code and these dupes who think Trump will only get the Blacks and Browns they don't like. But the goal is we hold hands at the end and sing Kumbaya.

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You go hug those hell bent on murdering your children’s future.

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Experience is the only teacher adults have. Everyone deserves a good teacher.

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Perhaps they are getting one in voting against their self interest. The question what will these people do next. They certainly have the opportunity to get in their congressionals’ faces and say no but will they bother? Who knows. It is stunning the number of people I come across who buy the opinion media lies.

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All very well, but how does that help the current situation? 70+million people voted for Trump. Do we patronize them all; do we owe them more understanding than they owe us? Their rationales are often religious and racial based: how to get past this? I just don't see how it helps! I want change but can't see how this effects it.

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I have no f*cks left to give for racists.

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Sometimes people who do something to their own detriment need to go all the way down. They have to lose a lot and need their noses rubbed in the loss. I think it is safe to say from top to bottom, MAGAts auto-propagandize on Faux Snooze all day, every day and believe the lies. Maybe this will start to break the loop. Better than many people on here, as a retired Internist, I understand what people without access to healthcare go through and if the rethugs succeed in killing Medicaid, you are going to see a huge rise in unavoidable deaths and medical bankruptcies (something which doesn't occur in any other industrialized democracy).

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But Harris and all other democrats also brand themselves as allies to the regular folks. Why Trump? I don’t want to believe they are all racist but it’s very hard to understand.

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Ignorance and believing lies explains 90% of it.

The right wing propaganda is very effective. I once read that Hitler first told a truth that everyone could believe, then he tied that to something that had a bit of truth and lies, then tied that to all lies. I listened to Rush Limbaugh with a friend of mine 40 years ago. That was exactly what he did. It's very effective.

Hearing lies over and over and over is also a very effective strategy.

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Leigh, with all due respect, maybe this is the only path forward for the country, long term—to finally make life so painful that this population of voters wakes up to the psychopathy and insanity of the GOP (a literal death cult) to ensure that future generations of poor and disenfranchised Americans don’t have to go through this, therefore saving more lives in the end.

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He was there for all to see. And this time he ran a foul, vile campaign of retribution against "enemies from within." And they cheered. They will never get my compassion, they don't deserve it.

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Their chasing Trump, much of it is about racism. We should have compassion for them and they do NOT have to have compassion for black and brown children trapped in poverty? THAT is why we have Trump and their medical care is up for grabs....their hate is the problem.

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did he condemn anyone other than the GOP

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You'll be excoriated for your views. You are supposed to be empathetic, compassionate; communicate with the victim; understand where they're coming from. On the other hand, if you deny people - adults - their agency, their ability to make their own decisions and be responsible for them - you are excoriated for that, too.

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I understand your position and you are not wrong. Just cannot believe how fast King Donald and Queen Elonia turn on their supporters.

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Why are you surprised? Trump is a con man. He's been one his entire life. He lies as he breathes. Furthermore, Trump gave his supporters throughout this country the right to shout their racism and hatred. He told them it's ok.

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Plus, thanks to SCOTUS he is immune for his actions, and the Republican members of Congress won’t impeach him. There are no remaining guardrails, so why would anyone expect him to suddenly develop any socially appropriate self-regulation? It’s been clear for decades he has no threshold of embarrassment.

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no surprise here, except if only Trump can fix it, what's Musk doing? Also, who should get top billing? is it the TM or MT regime?

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If only Trump can fix it we are screwed. Multiple trips to bankruptcy court. The only thing he ever tried to fix was an election! After he lost!

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If their only information came from Faux Noise, Xwiitter, and equally biased right-wing sources, they had no warning.

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Correct. I read an article in either the Post or the Times to the effect that all of Trump's ads talked only about high prices. Nothing about any of the stuff that was getting press coverage elsewhere. If you didn't see anything but Fox stuff and didn't read any press that wasn't a Murdoch rag, you couldn't see any of this coming.

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You might be on to something there.

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I think most people thought that Trump’s most radical ideas were bluster. Yes, by know people should know better, but he’s an effective snake oil salesman.

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When they only watch fox and listen to josh they weren't warned about any consequences of trump, only Kamala.

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I lived in WV for over 20 years, and you are right about how nice people can be there, but it is a clannish place, nonetheless. One way to understand this is that the poverty and ignorance has resulted in a kind of PTSD, and people who are traumatized often cling to imagined 'saviors' who promise to help. Kind of like a woman with low self esteem who marries a brute who lays it on thick that he loves her, she's beautiful, etc., and then proceeds to beat her half to death every time she fails to satisfy his insane and self-centered demands. When I see Trump & Co., I see echoes of this. These puffed up degenerates are sucking the life out of us in a creepily similar way.

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West Virginia could have been Colorado - they have mountains, rivers (with some of the best rafting anywhere), access to local agriculture, lots of outdoor activities, but even closer to large population centers. But they chose to embrace their underground natural resources and not their recreational resources and instead of prospering (year round) like Colorado they are a declining. Totally agree on an individual level lots of really nice people.

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as goethe said 'pity the poor german-so admirable in the individuality,so wretched in the collectivity.'

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They are nice unless you're Black. If you're Black they wish you dead and exclude you. A really fake niceness if you ask me.

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We do have the view that WVA is a state dominated by coal mining. The biggest employer in WVA are in health care and related fields. Coal mining employment has declined mostly because of automation. If we are going to hard rock mine coal we really do not want a large workforce as it is very dangerous.

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And besides, strip mining is cheaper and faster to allow the likes of Joe Manchin to really rake it in. Ditto blowing the tops off of those mountains.

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The preference for mining turns out to be an even worse choice with these factors - you are not getting jobs and ruining the landscape. Also as they have mined out the best coal seams they are now mining deposits with a lot more rock intermixed resulting in sky high cases of silicosis (black lung disease) which is a horrible way to die. Drive through the state and you will see competing billboards looking to hire new miners and looking to sign up existing miners to sue their employers for silicosis. The underfunding and industry capture of MSHA - driven by republican politics - makes this an even sadder story.

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Didn’t mining start before the age of mass tourism?

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Agree with you.

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Have you ever noticed that what Christian nationalists preach has nothing in common with Jesus’s teachings or the example he set? Jesus could not have cared less about people’s sex lives — not one mention of abortion or homosexuality but a lot of talk about caring for the least among us. That is why the Pope recently slapped down JD Vance’s twisted view of the obligations of Christian love and why he has been pushing right wing Catholic US bishops to focus on the teachings of Jesus, not on culture wars.

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YUP I noticed....a cult is more like it hiding behind a popular NAME but acting how they choose..not how Christ would ACT

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right-it's a popular name-good politically to claim to be religious,esp.christian

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If you ever attend one of their services, you'll see that they don't preach Christ. They preach Paul.

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Christian Nationalists are not Christian. They are Old Testament believers - the ones who were disappointed that Christ didn't come here to become a warrior king. Christianity is all about the sermon on the mount and the sermon at the last supper. It is not about punishing the poor.

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they HIDE behind the word Christian..if Christ where to show up ;) he would NOT APPROVE - no no no - NOT Christ like behaviour ...THEY ARE NOT CHRISTIAN...more cult like really

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"Jesus was a Capricorn, he ate organic foods. He believed in love and peace and never wore no shoes. Long hair, beard, and sandals, and a funky bunch of friends. Reckon they'd just nail him up if he came down again." - Kris Kristofferson.

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Or punishing homosexuals or banning abortion.

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Please explain what you mean by Old Testament believers?

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I disagree. Christianity as centuries of nasty, reactionary behavior of all kinds. It is a weakness that Christians should be on guard for. Religionists welcomed the liberalist order and religionists have tried to destroy the liberalist. Reserving some view of 'true' Christianity is unwarranted.

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Gnostics.

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6hEdited

One way to look at it is that Team Fossil Fuel is in an existential goal line stand; and that there is sense in which Joe Manchin, Donald Trump, and Vladimir Putin play for the same team.

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Yeah - team extinction.

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But the balance sheet looked good almost to the end,... .

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Only because the books have been cooked.

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There’s remarkable support for Putin among Republicans.

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First, I would argue that the Bushes, the Koch brother(s) etc. were/are are all on the same team; and second, for almost a decade it has been a MAGA article of faith that "Russia" is a hoax--despite thousands of pages of report to the contrary.

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Thry might be wonderful, kind people, but they are largely white and never ever think that they might lose benefits. It will only be THOSE PEOPLE ( code for people of color) who havr been stealing their benefits. If WV suffers a wave of hospital closures and worse health, thry brought it on themselves. I am not wasting my sympathy on racists and fools.

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You meant to say Medicaid, not Medicare... There are many reasons for the rightward shift- guns, a general belief in libertarianism, etc.. Krugman has written many articles about the demise of high paying (but very risky) coal jobs in W VA. The right blames it all on the libs, which is partially true (Coal combustion and mining are awful for health and the climate), but more of the job losses can be explained by mechanization. I sadly believe the only way for certain people to change how they vote is when they lose their jobs and their health insurance while also experiencing higher inflation on the stuff they buy (think Walmart crap and eggs).

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Thank you for clarifying Medicaid, not Medicare, is the immediate target for reductions. As for people changing their voting habits after they lose jobs and experience inflation, they didn’t after the 1981-1983 recession and haven’t changed since then. Despite manufacturing and natural resource extraction employment declining by 10-15% and inflation running above 5%, the voters most harmed by that recession voted for Reagan again. Over the past 50 years “Republican” has become an identity cult, not a political party. I once had some hope younger generations would become the solution to this problem, but the results of the 2024 election showed they are just as susceptible to identify politics as their parents and grandparents. Sigh.

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That's because the damage by Reagan didn't hit them hard enough to change their vote. This time, they're gonna get hit good and hard. That might just be enough to wake them up.

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Sorry for the mistake! I do know the difference between the budget deficit and the national debt.

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It seems to cult like features, like the inability to listen to even mild criticisms of Trump.

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And there you have struck upon why the GOP administration and Congress arrogantly believe they can harm their voters as much as they want to support the top 1% and still retain the votes

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SS officers were very nice, too. Had puppies, loved their kids. So?

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Exactly, this.

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I think we have seen the rise of 'Republican Jesus'. I remember one of the higher-ups in the Southern Baptist Convention lamenting in the last couple of years that his flock were telling him the Beatitudes were too woke...

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5hEdited

Christian Nationalists are the latest version of the KKK. No stupid hats and robes though...

Yes, WV, and other ruby red states, bought the trump BS hook, line, and sinker. And now they will be struggling like a fish out of water for taking the hook again..

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Well, they do have a stupid red hat that identifies them

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That's true. You can see, them coming from a mile away.... I think they wear those caps to hide their pointy little heads.

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The people in need voting for Trump have a fatalist approach to their lives. The Calvinist theology requires that if they are not predestined by the grace of God to life enjoyment then must suffer enough to convince God thay there has been a mistake and they belong under His Grace.

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I don't know about that. I do know that the church in western North Carolina in which my mother was raised put a great deal of emphasis on the sanctity of poverty. The gospel says something like "It is easier for a camel to pass through the eye of a needle than for a rich man to get into Heaven."

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West Virginians have a mental issue. They voted for a mean, racist guy to run the programs they depend on. And most of all, it is extremely anti-Christian of them to do so. They are not innocent victims. They give the guy the knife to cut us with and this white game is we all hand wring and try to pretend how innocent they are now?

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Thank you for this. I, too constantly remember singing that in church. "They will know we are Christians by our love". And being stunned that so many folks who claim to be Christians putting up "mass deportation now" signs and "they're eating the cats and dogs". And the like. That does not seem like love to me.

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Amen

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They believe in eugenics. They are afraid of homosexuals and trans people, they see them as the dawn of an evil era. They are very childish and immature. Jesus for them is an orderly world. They call upon Jesus to create a world where whites are highly placed and all people of color are lowly placed. For this segment of society, Christianity is a means to impose homogeneity and conformism on the world. It is an anemic world view and I am glad that the horrific consequences of these valurs are so readily visible at this time. Christians are not about love tolerance or humanity. They are about control and power and even genocide. It is time to eviscerate the Christian movement which is seeking to impose a rigid and ruthless theocracy on America, to eradicate sexual freedom, eradicate reproductive freedom, re-enslave Blacks, crush women and force them back into the kitchen.

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Gutting Medicaid would be catastrophic for health care from hospitals to sold practitioners. The community mental health services systems across USA would shut down. People would die. We need a general strike. Everyone stay home

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We need the infrastructure for that. Where’s the billion-dollar strike fund? Who is administering it? Who funds it?

We have done nothing to prepare for the obvious.

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Exactly. Calling for a general strike when the US working class can’t even manage to organise car manufacturing in the South seems a little….ambitious. No?

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Let us not forget, many want to strike, but putting a roof over their heads and feeding their children must come first. Reality sucks

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That’s precisely the point. Strikes are important, but the US working class is, shall we say, a bit out of practice lately. Calling for a general strike in those circumstances is simply childish performative nonsense, typical of the US left.

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Unions have been decimated and now we see why we need strong unions. America will not be a safe place to live if sick people become homeless beggers and children who don't get vaccines and health care start dying. Disease and poverty will explode from the inner cities onto all the pretty suburban streets.

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As a physician working in a lower income area, I am grateful that Medicaid allows me to take care of people so that they don't suffer and die from catastrophic neglected diabetes, heart disease and cancer. Babies can be born healthy. Counter to the lies being put out there, undocumented patients are not eligible for Medicaid. Emergency medicaid could apply to undocumented, but only for emergency treatment, which saves hospitals from bankruptcy when they are required to teat anyone who walks through the door. Also, pregnant women can all get emergency medicaid during their pregnancies which more than pays for itself avoiding horribly expensive care for premature and terribly sick newborns. Only sociopaths want millions of people to suffer so that a few people can add to their excess.

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I know three doctors (Canadians), who returned to Canada after stints in the U.S. because, as one described it to me, "even though I make less money in Canada, in Canada I can practice medicine", precisely the environment you describe.

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I do not understand why people accept this.

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”Probably the most well-known scientific journal Nature writes a very serious editorial calling on the entire global research community to raise their voices. The freedom of research and the basic conditions for work are now being systematically attacked in the United States and affect the whole world.

Nature writes about how the Trump regime's attack on science means that thousands of scientists have been laid off, how funding is frozen and how certain words in scientific reports are banned. The repressive restrictions we see the repressive and authoritarian Trump regime subjecting research to hit the entire global research. It dismantles basic infrastructures such as databases and digital services, which directly threatens research worldwide, and our ability to conduct independent and evidence-based studies.

Nature further writes that grant review panels at the National Institutes of Health have been suspended, that USAID has put most of its 10,000 employees on furlough and made buildings and sites inaccessible. The consequences are dire – at least one million women have lost access to contraception, the United States plans to leave the World Health Organization, and all federal funding for international climate projects, equivalent to $11 billion (10% of global climate finance), has been suspended.

When research in the world's leading research nation falls silent under political repression, our ability in Europe and the world at large to fight climate change, respond to pandemics and develop technologies that are crucial for security and sustainability is also weakened. What we are now seeing is a systematic attack on science.

It is clear that an attack on American academic freedom not only harms democracy there, but also has repercussions for research and science throughout the world. The world is becoming a darker and more dangerous place. Less rich in thoughts, ideas and insights.

As researchers, we must contribute to making visible what is happening. We must stand up for those who are threatened with censorship, demand that these restrictions be lifted and remind that a world without free research is a world where prejudice and oppression risk replacing critical thinking and scientific progress.”-Carl Heath, RISE

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It's also really bad for business. Destroying R and D, and the regulatory agencies that give assurances of safe and effective are terribly damaging.

I don't think they are doing it purposefully, but Trump is ignorant except of entertaining and grifting, and Musk is limited to anything but his chose passion. Right now he's fixated on ruling the world, which means crushing anyone who gets in his way.

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Heres a link to one of the open access editorials from Nature: https://www.nature.com/articles/d41586-025-00562-w

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My son is an avid player of video games - but he is also politically aware. We were talking this morning about the destruction of USA and he summed it up quite neatly in his 'gamer' language. "I'll be really glad when this is all over", he said, "feels like we're playing life permanently stuck in hard mode'.

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Professor Krugman: anyone who has been paying attention over the last few decades knows that the GOP is the party of "Greed Over People". and, as you noted in this piece, rethuglicans are proud to vote for the GOP because they expect their party will focus their hatred and viciousness on "Those People" rather than gawd-fearing white people, such as themselves.

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Something the other side never thinks about: People without access to healthcare get sick and spread disease. Even if a person is completely selfish, as Republicans are, that alone should be enough for them to want everyone to have access to healthcare so that THEY don't get sick! But, they don't see this because they are completely blinded by their hate for vulnerable people.

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They don’t care because “I am not one of those people, associate with those people or know anyone who is or does. No reason to worry because I am safe.” Short sighted, unimaginative thinking, but here we are.

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OMG! You nailed it with “unimaginative”! I’m going to start using that word, too.

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Some diseases for which there’s a vaccine are making a comeback. Big outbreak of measles in Texas. One child has died. But the vaccinated are mostly unaffected.

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Might be in for a rude surprise, yes?

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"Those people" are Blacks and Hispanics. Race will destroy us if we don't get the WWC's to cut it out.

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Thanks for the facts about Medicaid. I'm not so poor, so I didn't know much about it. Politically, it seems that the Trump Party's efforts to gut it might rebound in their faces. But, they do have a way of blaming their faults on the Democrats. Look for those poor folks in W VA to think that somehow it was Joe Biden who took away their benefits.

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Speaking of "overpriced drugs" and inefficiencies…

I'm on Medicare with Part D drug coverage. I take Eliquis the costly blood thinner.

In 2020, the FDA approved two versions of Apixaban, the Eliquis generic, for the US noting, “Today’s approvals of the first generics of apixaban are an example of how the FDA’s generic drug program improves access to lower-cost, safe and high-quality medicines”.

Big Pharma, in the form of the Axis-0f-Evil "Bristol-Myers-Squibb-Pfizer-Alliance" howled. In 2021 they sued the FDA and got a patent extension till '28 - to milk more $$ from America!!

What's the point? Eliquis costs $650 for the 1st refill, then $270/refill the rest of the year. Next year? Same-same.

Screw that! I got a copy of the script from my doc, sent it to a Canadian pharmacy that charges $105 for every refill of Apixaban, made in the UK, saving me over $1000/yr.

How about DOGEing that one, Muskovite???

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Never happen. Never their goal. Their goal is to make everything far more expensive - more profitable and to privatize central gov functions (PO, Weather, FAA).

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Did you check pricing on GoodRx or Mark Cuban’s website? Or check which part d insurers include eliquis on their formularies so your yearly out of pocket drug costs would be capped at $2000? I’m a SHIP volunteer and help seniors navigate these waters all the time. I’m guessing you didn’t ask for any help.

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Thx Susan, I did check those sources, but via our former-allies, Canada and the UK, i'm buying Apixaban at the price the WHO negotiated (as I understand it) of $95 + shipping. My annual cost will be $420 (meaningful to this old hippie-chick) and I don't take any other meds, so no danger of hitting the $2k max. Thanks for your good work. Anne

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As a person who came to WV as a young adult and closed out my therapy career there, working in a clinic that served the underserved I could never fully understand how so many 'real' West Virginians were voting for Republicans, even though most of my clients had Medicaid, SNAP, Head Start, and similar benefits largely unrolled and supported by Democratic administrations. One fine day when a member of WV's Supreme Court came to town the two of us sat at the corner table of the towns sole brewery bar and I asked him about it. He said, "It's because of what they hear preached at them from the pulpit every Sunday." Hmm. And how is it that those churches haven't lost their tax free status for violating the separation of church and state? And how is it that supposed Christians are so benighted? OMG.

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The result of not being thought how to think, to analyze information. I think it’s a long term goal of republicans and now you are seeing the result.

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“We are what we always were in Salem, but now the little crazy children are jangling the keys of the kingdom, and common vengeance writes the law!”

― Arthur Miller, The Crucible

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Nursing homes! Medicaid is *the* source of their funding. That's the only way most people can have nursing home care - burn all your assets paying for it, then go on Medicaid.

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I think the internal dynamic of these red states is that it's local country club crowd (the folks who own the car dealerships, fast food franchises, rental properties - all non-traded goods) who fund the state and republican apparatus that want to cut Medicaid because they don't want to pay the state tax contribution to these programs.

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And the gerrymandering that makes State Houses unrepresentative, Congressional representation ditto, and US Senate apportionment a global disgrace.

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Dunno. Tennessee has no State income tax and is solidly Republican. IIRC, it also didn't buy into the Medicaid expansion program.

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My nephew is on Medicaid. Why? He has Down Syndrome and is unable to work the kind of job that would support him much less provide insurance coverage. I suspect that many of us have friends or relatives who will be hurt, if not hurt themselves. He lives in the reddest county in WI. His caregiver, paid by SSI, is hardcore MAGA. We're waiting for that show to drop

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Medicaid doesn't seem to have THE issue that Congress forced on Original Medicare!!! But Congress allowed Insurance to have!!

Out of pocket cap, limits personal liability and bankruptcy. And a drug plan

Original Medicare has no cap on your out of pocket costs. OM is taken by 100% of Doctors and Hospitals. You have unlimited liability.

But Congress allowed Supplement and Advantage to provide maximum out of pocket cost liability! Why? How do they fund this?

Insurance creates micro monopolies called Networks. This forces customers to choose and providers to choose. This forcing function creates profit from premiums and cash margin from the payment my Medicare to Insurance and the lower Insurance to Provider

It appears Medicaid has no limit on coverage. Everything is paid. And it has a drug plan. Original Medicare does not. You have to get Part D from private insurance with premiums and copays while Insurance pockets the negoatiated savings.

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Something that a lot of people don't realize is that Medicare doesn't cover longterm care. For middle class families with an older person who needs to be in a nursing home because cognitive or physical frailties make them unable to perform activities of daily living (which is a bar often far higher than the point at which someone can't safely be on their own, especially for cognitive decline -- a whole other can of worms in how the US manages eldercare), the only viable route is to spend down assets until the person qualifies for Medicaid. That population not only doesn't fit the stereotype of inner-city (read non-white) poverty, it isn't a demographic that in terms of lifetime socioeconomic status is poor at all. And cutting off that route would, like so many Republican policies, disproportionately impact women, who do the majority of caregiving.

Incidentally, caregiving is also a major reason why someone might be on Medicaid when they could theoretically be employed. I was on Medicaid while I was a caregiver for parents. I was working. I was doing a full time, indeed, 24/7 job that was both physically demanding and highly skilled. I just wasn't being paid for it.

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Americans still think that the remedy for these situations lies in the ballot box: piss off enough people and they'll vote for another party. However, this doesn't work in autocracies, and you're a full-blown one now, if you look at every marker.

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5hEdited

Yeah, you’re right, these thugs are not going to give up power without bloodshed. The only way this will end is through the barrel of a gun. The Guardian this morning has an article on the fear republicans in Congress are feeling from threats and intimidation by his goons. And this has been going on for years. Add Thugocracy to the list of all the other -ocracies used to describe this reign of terror. It’s just a matter of time before this spirals into violence, I’m sorry to say.

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Yup, I’ve been saying this for some time now. People are rising up, there have been protests & demonstrations all over the country. And this movement is growing. It’ll only be a matter of time when Trump will ‘be forced to take action’ and voilà! MARTIAL LAW. And in that very moment, you can kiss your civilian government (already in disarray) AND your democracy goodbye. All part of the plan. Here’s a prophecy no one paid enough attention to last summer… On July 2, 2024, Heritage Foundation president Kevin Roberts created controversy by saying, "we are in the process of the second American Revolution, which will remain bloodless if the left allows it to be." By the end of that month, Kevin Roberts assumed leadership of Project 2025 when the previous director stepped down ‘to concentrate on the election’.

All. Part. Of. The. Plan.

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Yes, I used that quote in a letter to the editor of another publication back last fall. I still remember the feeling I got when first reading it.

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After the GOP fell in line on the budget, I suspect that they not only fear being primaried but they also fear the MAGA brown-shirts will attack them and their families. That was the beauty of pardoning all of the Jan.6th criminals. Thugs for Trump are now immune from prosecution.

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